1. 1 Background  CCG keen to explore collaborative working through a LES mechanism  One of functions of the Fed is to facilitate collaborative working  Fed looked at schemes which are  Practical  Impact practice workload  Evidence based  Some schemes attractive but difficult to implement in short term e.g.  Home visiting service – cannot recruit NPs on 1 to 2 year contracts  Assertive Community Treatment for mental health – need mental health trust to lead Update on Over 75s

2. 2 Proposal for discussion  Of initial £2.50, £1.62 plus 36p to practice schemes a)Special Patient Notes – 42p b)Yellow folders – 42p c)Visits to housebound with LTCs – using model developed by SBS – 42p plus 36p  Of initial £2.50, 88p to collective schemes a)InstantCare b)Discharge coordinators  Outcome £2.50 – all to practices, no Fed top slicing  32 practices want to look at Fed proposal, 6 DHG practices working together, 3 doing own thing

3. 3 Special Patient Notes If all practices achieved level of Haven Health = additional 3,233 notes = 90% increase Patients with SPN 50% less likely to require an ambulance and 80% less likely to be referred to A&E

4. 4 Implementation plan  Fed dealing with paperwork – no action needed by practices for now  Submissions made to trigger £2.50 payment less the 88p  May/June  Public engagement plan developed  Practice delivered schemes - Fed work-up detailed implementation packs and organise training if needed  InstantCare should be able to start early  Recruit discharge support teams  July – services commence  Regular feedback to practices  Discuss at future shutdowns